PMMA-10610 An estimation of the willingness to pay for community healthcare risk-sharing prepayment scheme in rural Nigeria


Health care financing in Nigeria especially for the rural poor, where the bulk of the population reside is a major problem. This is because of the predominance of out-of-pocket payment and the immediate effect of this method of health care payment is catastrophic to poor households and further impoverishes them. Prepayment schemes for rural communities can be used as an option of increasing access to health care services and these schemes have not received considerable attention in Nigeria. In this regard, we proposed a poverty alleviating community health care prepayment scheme to shield the poor from the adverse effect of health care payments. Investigating the willingness of households to pay for such schemes, the study shows that community members are willing to participate with a high confidence level. Employing a variant of methodologies, households were willing to pay varied amounts. The use of commodities as a medium of payment produced higher results than the traditional use of monetary measures as has been shown to increase participation in other countries like India. Incorporating uncertainty into decision making, produced results that are larger than that ignoring the possibility of uncertainty owing to the high degree of confidence. Factors identified in predicting the amount were income, age, gender, knowledge of health insurance, health status, confidence in any community trust fund, ownership of toilet facilities, and distance from household to the nearest health centre. The most vulnerable groups with respect to health care financing in the rural population are identified as women, the old, less educated and the poor. The study provides policy prescriptions which include targeting the most vulnerable within the community through the use of sliding premiums scale, use of varied forms of payment, use of external funding to augment where necessary, local capacity building, renewed government commitment to increasing health care financing, and possibility of integrating such schemes into a broader scheme to enlarge the risk pool and provide access to a broader benefit package as a move to achieving a reduction in the increasing medical poverty trap phenomenon in rural Nigeria.


Project leader: John Ataguba

Project researchers: Hyacinth Ichoku Ementa | William Fonta | Mba Ifeoma christy

Journal publication

Authors Co-Authors Title of paper Title of Economic Review Bibliographic references
John Ataguba Hyacinth Ichoku Ementa,William Fonta Estimating the Willingness to Pay for Community-Based Health Insurance Schemes in Nigeria: A Random Valuation Framework The IUP Journal of Risk & Insurance

01(2010) Vol. 7, pp. 7-27

Working Papers

Title Modified Size Comments Recommendations
Estimating the willingness to pay for community healthcare insurance in rural Nigeria 2008-05-15 569.41KB 0 0

Policy Briefs

No policy briefs.

Final report

Title Modified Size Comments Recommendations
2007-09-26 708 KB 0 1


Title Modified Size Comments Recommendations
2006-05-14 308 KB 3 0

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